What is an Annual Maximum Benefit?
Under most Dental PPO’s and Indemnity (free choice of provider plan) you will notice that they have an annual maximum benefit. The maximum limitation per person per year normally ranges at around $500.00-$2000.00 depending on the plan you are reviewing.
But what is a maximum limitation? A maximum limitation is the dollar amount the insurance company is willing to spend per person per calendar year. Such as: Say you have a $1000.00 maximum limitation for a three person family plan, that means each person has a maximum limitation of $1000.00 say from January 2016 to January 2017. Now say one person needs $4000.00 in dental work in a given year. If you do not want to go over your annual maximum benefit you want to make sure you schedule services at the end of one year and the being of next to help reduce your risk of going over your annual maximum benefit and being charged the differences. Please note this example is not taking into account any waiting period or deductible that may be applicable to this plan type specially within the first year of having the dental insurance plan.